This project is an extension of Project Z01 ES 50006-01 in which signals were imparted into the ossicular chain by normal acoustic methods and by direct activation by piezoelectric type transducers, and the resulting inner ear responses electrophysiologically recovered and subsequently presented to listener panels in discrimination tests. The current project was designed so that listener panels could compare electrophysiologically recovered speech initiated by (1) normal acoustic presentation (2) processing through hearing aids (3) by direct activation by piezoelectric type devices. Further, pilot project results indicated the existence of differences between the hearing aid versus acoustic and PZT methods of presentation which were not accounted for by word discrimination tests alone. Therefore a new (listener) test paradigm including paird comparison quality ratings were instituted. Preliminary results indicate relative parity between the normal acoustic and direct ossicular chain activated (PZT) methods with both being superior to hearing aids. The differences appear to be dramatic in the quality rating category.